脱钙人牙基质材料联合髂骨与单纯髂骨移植修复牙槽突裂的对比性研究

目的:研究牙槽突裂植骨修复的新方法.方法:A组62 例(74 侧)牙槽突裂患者采用单纯髂骨松质骨移植修复牙槽突裂,B组26(30 侧)例采用自体髂骨松质骨混合脱钙人牙基质材料植入牙槽突裂术区.对2 组88 例牙槽突裂患者,均于术前、术后1 周,1、2、3、6 个月和1 年摄全口曲面断层X线片及上颌前部咬合X线片,结合临床,观察骨愈合、骨吸收的情况及伤口愈合情况,根据术后3 月X线片,按Bergland等的评价标准进行分级,对2 组不同植骨材料的术后效果进行总结分析. 结果:A组Ⅰ级17 例17 侧(23%),Ⅱ级17 例20 侧(27%),Ⅲ级13 例14侧(19%),Ⅳ级15 例23 侧(31%);植入骨成活率为68.9%,临床成功率为50%.B组Ⅰ级 16侧(53%),Ⅱ级8 侧(26%),Ⅲ级4 侧(13%),Ⅳ级2 侧(6%);植入骨成活率为93.3%, 临床成功率为80%.结论: 采用脱钙人牙基质材料联合髂骨松质骨修复牙槽突裂,骨诱导作用明显,能减少骨的吸收,加速新骨形成,比单独应用髂骨植骨能明显提高临床成功率.

Comparison of autologous ilium spongy bone combined with human decalcified dentinal matrix in alveolar process cleft bone grafting

Objective: To study a new method of alveolar cleft bone grafting. Methods: Group A: 62 cases (74 sides) alveolar cleft patients were transplanted with self-ilium spongy bone. Group B: 26 cases (30 sides) alveolar process patients used autologous ilium combined with DDM. Anterior occlusal radiographs and panoramic oral radiogram were taken before and after the operation to observe if there was new bone formation in the bone grafting area. According to Bergland grade criterion, analyzed the X-ray results after 3 months of the operation. Results: Group A: 17cases(17 sides) in class 1 group(23%), 17 cases(20 sides) in class 2 group(27%), 13 cases(14 sides) in class 3 group (19%), 15 case(23 sides) in class 4 group(31%). The overall survival rate of ABGR was 68.9%, and the clinical success rate was 50 %;Group B:16 cases(16 sides) in class 1 group(53.3%), 7 cases(8 sides) in class 2 group(26.7%), 2 cases(4 sides) in class 3 group (13.3%), 1 case(2 sides) in class 4 group(6.7%). The overall survival rate of ABGR was 93.3%, and the clinical success rate was 80%. Conclusion: Ilium spongy bone combined with DDM is good for alveolar process cleft bone grafting. It is better to use decalcified dentinal matrix of human than autologous ilium spongy bone.